U.S. DOD Form dod-dd-293
APPLICATION FOR THE REVIEW OF DISCHARGE
FROM THE ARMED FORCES OF THE UNITED STATES
Form Approved
OMB No. 0704-0004
Expires Aug 31, 2006
(Please read instructions on Pages 3 and 4 BEFORE completing this application.)
The public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection
of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0004). Respondents should be aware
that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB
control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION. RETURN COMPLETED FORM TO THE APPROPRIATE ADDRESS ON
BACK OF THIS PAGE.
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 1553; E.O. 9397.
PRINCIPAL PURPOSE(S): To apply for a change in the characterization or reason for military discharge issued to an individual.
ROUTINE USE(S): None.
DISCLOSURE: Voluntary; however, failure to provide identifying information may impede processing of this application. The request for
Social Security Number is strictly to assure proper identification of the individual and appropriate records.
1. APPLICANT DATA (The person whose discharge is to be reviewed). PLEASE PRINT OR TYPE INFORMATION.
a. BRANCH OF SERVICE (X one)
ARMY
MARINE CORPS
b. NAME (Last, First, Middle Initial)
NAVY
AIR FORCE
c. GRADE/RANK AT DISCHARGE
COAST GUARD
d. SOCIAL SECURITY NUMBER
2. DATE OF DISCHARGE OR SEPARATION 4. DISCHARGE CHARACTERIZATION RECEIVED (X one) 5. BOARD ACTION REQUESTED (X one)
(YYYYMMDD) (If date is more than 15 years
ago, submit a DD Form 149)
HONORABLE
CHANGE TO HONORABLE
GENERAL/UNDER HONORABLE CONDITIONS
CHANGE TO GENERAL/UNDER
HONORABLE CONDITIONS
CHANGE TO UNCHARACTERIZED
(Not applicable for Air Force)
CHANGE NARRATIVE REASON FOR
SEPARATION TO:
UNDER OTHER THAN HONORABLE CONDITIONS
3. UNIT AND LOCATION AT DISCHARGE
OR SEPARATION
BAD CONDUCT (Special court-martial only)
UNCHARACTERIZED
OTHER (Explain)
6. ISSUES: WHY AN UPGRADE OR CHANGE IS REQUESTED AND JUSTIFICATION FOR THE REQUEST (Continue in Item 14. See instructions on
Page 3.)
7. (X if applicable) AN APPLICATION WAS PREVIOUSLY SUBMITTED ON (YYYYMMDD)
AND THIS FORM IS SUBMITTED TO ADD ADDITIONAL ISSUES, JUSTIFICATION, OR EVIDENCE.
8. IN SUPPORT OF THIS APPLICATION, THE FOLLOWING ATTACHED DOCUMENTS ARE SUBMITTED AS EVIDENCE: (Continue in Item 17.
If military documents or medical records are relevant to your case, please send copies.)
9. TYPE OF REVIEW REQUESTED (X one)
CONDUCT A RECORD REVIEW OF MY DISCHARGE BASED ON MY MILITARY PERSONNEL FILE AND ANY ADDITIONAL DOCUMENTATION
SUBMITTED BY ME. I AND/OR (counsel/representative) WILL NOT APPEAR BEFORE THE BOARD.
I AND/OR (counsel/representative) WISH TO APPEAR AT A HEARING AT NO EXPENSE TO THE GOVERNMENT BEFORE THE BOARD IN THE
WASHINGTON, D.C. METROPOLITAN AREA.
I AND/OR (counsel/representative) WISH TO APPEAR AT A HEARING AT NO EXPENSE TO THE GOVERNMENT BEFORE A TRAVELING PANEL CLOSEST TO
(NOTE: The Navy Discharge Review Board does not have a traveling panel.)
(enter city and state)
10.a. COUNSEL/REPRESENTATIVE (If any) NAME (Last, First, Middle Initial) AND ADDRESS b. TELEPHONE NUMBER (Include Area Code)
(See Item 10 of the instructions about counsel/representative.)
c. E-MAIL
d. FAX NUMBER (Include Area Code)
11. APPLICANT MUST SIGN IN ITEM 13.a. BELOW. If the record in question is that of a deceased or incompetent person, LEGAL PROOF OF
DEATH OR INCOMPETENCY MUST ACCOMPANY THE APPLICATION. If the application is signed by other than the applicant, indicate
and relationship by marking a box below.
the name (print)
SPOUSE
WIDOW
WIDOWER
NEXT OF KIN
LEGAL REPRESENTATIVE
OTHER (Specify)
b. TELEPHONE NUMBER (Include Area Code)
12.a. CURRENT MAILING ADDRESS OF APPLICANT OR PERSON ABOVE
(Forward notification of any change in address.)
c. E-MAIL
d. FAX NUMBER (Include Area Code)
13. CERTIFICATION. I make the foregoing statements, as part of my claim, with full knowledge of the
penalties involved for willfully making a false statement or claim. (U.S. Code, Title 18, Sections 287
and 1001, provide that an individual shall be fined under this title or imprisoned not more than 5 years,
or both.)
a. SIGNATURE - REQUIRED (Applicant or person in Item 11 above)
DD FORM 293, MAR 2004
CASE NUMBER
(Do not write in this space.)
b. DATE SIGNED - REQUIRED
(YYYYMMDD)
PREVIOUS EDITIONS ARE OBSOLETE.
Reset
Page 1 of 4 Pages
14. CONTINUATION OF ITEM 6, ISSUES (If applicable)
15. CONTINUATION OF ITEM 8, SUPPORTING DOCUMENTS (If applicable)
16. REMARKS (If applicable)
MAIL COMPLETED APPLICATIONS TO APPROPRIATE ADDRESS BELOW.
ARMY
Army Review Boards Agency
Support Division, St. Louis
9700 Page Avenue
St. Louis, MO 63132-5200
(See http://arba.army.pentagon.mil)
AIR FORCE
Air Force Review Boards Agency
SAF/MRBR
550-C Street West, Suite 40
Randolph AFB, TX 78150-4742
DD FORM 293, MAR 2004
NAVY AND MARINE CORPS
Naval Council of Personnel Boards
720 Kennon Street, S.E.
Room 309 (NDRB)
Washington Navy Yard, DC 20374-5023
COAST GUARD
U.S. Coast Guard
Commandant (G-WPM)
2100 Second Street, S.W. Room 5500
Washington, DC 20593
Reset
Page 2 of 4 Pages
INSTRUCTIONS FOR COMPLETION OF DD FORM 293
REQUESTING COPIES OF YOUR OFFICIAL MILITARY
PERSONNEL FILE
Information on how to obtain military or health
records is available at the National Personnel Records
Center website at www.nara.gov/regional/mpr.html or at
your local Veterans Administration office.
Applicants are strongly encouraged to submit any
request for their military records prior to applying for a
discharge review rather than after submitting a DD Form
293 in order to avoid substantial delays in processing of
the application and scheduling of review. Applicants and
their counsel may also examine their military personnel
records at the site of their scheduled review prior to the
review. The Board shall notify applicants of the date of
availability of the records for examination in their
standard scheduling information.
Submission of a request for an applicant's military
records (including a request pursuant to the Freedom of
Information Act or Privacy Act) after the DD Form 293
has been submitted will automatically result in the
suspension of processing of the application for discharge
review until the requested records are sent to an
appropriate location for copying, are copied, and are
returned to the possession of the headquarters of the
Discharge Review Board. Processing of the application
shall then be resumed at whatever stage of the discharge
review process is practicable.
DD FORM 293 - PLEASE PRINT OR TYPE INFORMATION.
(Items on the form are self-explanatory unless otherwise
noted below.)
ITEM 1b. Use the name which you served under while in
the Armed Forces. If your name has since changed, then
also include your current name after adding the
abbreviation "AKA". If the former member is deceased
or incompetent, see Item 11.
ITEM 2. If you received more than one discharge, the
information in this item should refer to the discharge that
you want changed. Discharge Review Boards cannot
consider any type of discharge resulting from a sentence
given by a general court-martial.
ITEM 3. If the discharge you want reviewed was issued
over 15 years ago, instead of applying on a DD Form
293, you must petition the appropriate Board for
Correction of Military Record using DD Form 149,
Application for Correction of Military Record Under the
Provisions of Title 10, U.S. Code, Section 1552.
ITEM 5. If you request a change of narrative reason for
separation, you must list the specific reason for discharge
that you believe to be appropriate, otherwise the Board
will presume that you do not want a change in reason for
discharge. If you do not request a change of discharge
characterization in this item, the Board will presume you
want to change discharge to Honorable.
If you were separated on or after 1 October 1982
while in an entry level status with an under other than
honorable conditions discharge and less than 180 days of
active service, you can request a change of discharge
characterization to "Uncharacterized" and discharge
reason to "Entry Level Separation".
DD FORM 293, MAR 2004
ITEM 6. "Issues" are the reasons why you think your
discharge should be changed. You are not required to
submit any issues with your application. However, if you
want the Board to respond in writing to the issues of
concern, you must list your specific issues in accordance
with those instructions and regulations governing the
Board. Issues must be stated clearly and specifically.
Your issues should address the reasons why you believe
that the discharge received was improper or inequitable. It
is important to focus on matters that occurred while you
served in the Armed Forces.
The following examples demonstrate one way in which
issues may be stated (the example issues do not indicate,
in any way, the only type of issues that should be
submitted to the Board):
Example 1. My discharge was inequitable because it
was based on one isolated incident in 28 months of
service with no other adverse action.
Example 2. The discharge is improper because the
applicant's pre-service civilian conviction, properly listed
on his enlistment documents, was used in the discharge
proceedings.
In Item 6 list each of your issues that you want the
Board to address. There is no limit to the number of
issues that you may submit. If you need additional space,
continue in Item 14 or on a plain sheet of paper and attach
it to this application.
NOTE: If an issue is not listed in Item 6, it may result in
the Board not addressing the issue even if the issue is
discussed in a legal brief or other written submissions or at
the hearing. Changes or additions to the list may be made
on the DD Form 293 anytime before the Discharge Review
Board closes the review process for deliberation. Please
be sure that your issues are consistent with the Board
Action Requested (Item 5). If there is a conflict between
what you say in your issues and what you requested in
Item 5, the Board will respond to your issue in the context
of the action requested in Item 5. For example, if you
request a General Discharge in Item 5 but your issue in
Item 6 indicated you want an Honorable Discharge, the
Board will respond to the issue in terms of your request for
a General Discharge. Therefore, if you are submitting
issues for the purpose of obtaining an Honorable
Discharge, be sure to mark the box for an Honorable
Discharge in Item 5.
Incorporation by Reference. Issues that are listed on a
legal brief or other written submissions may be incorporated by reference in Item 6. The reference must be
specific enough for the Board to clearly identify the matter
being submitted as an issue. At a minimum, it shall
identify the page, paragraph, and sentence incorporated.
Example: Issue 1. Brief, page 2, paragraph 1, sentences
one and two.
Applicants should be as specific as possible with all
references so the Board can clearly distinguish the scope
of the issue. Because it is to your benefit to bring such
issues to the Board's attention as early as possible in the
review, if you submit a brief, you are strongly urged to set
forth all such issues as a separate item at the beginning of
the brief.
Page 3 of 4 Pages